Treating Multiple Myeloma

Our Interdisciplinary Approach

At Roswell Park, we believe that diagnosing and treating multiple myeloma requires input from experts in different fields of oncology. Our tumor board brings together specialists from several departments to identify the best diagnostic and treatment approaches for every single patient. In cases where standard treatment options have failed, we try to find new targets of therapy to provide additional treatment options.

We work closely with the Cancer Survivorship and Supportive Care Center and Rehabilitation Therapy and Wellness Services teams to ensure that our patients enjoy the highest quality of life. A team led by Jens Hillengass, MD, investigates ways of better evaluating quality of life and learning how to improve this important part of the patient experience.

Treatment Options

Today there are numerous treatment options for multiple myeloma. Your treatment plan will depend on what treatments you’ve had in the past, any other medical conditions you might have (comorbidities) and your personal preferences.

Treatment for multiple myeloma can include systemic (whole-body) options, such as proteasome inhibitors, immunomodulatory drugs, antibodies, histone deacetylase inhibitors, antibody-drug conjugates, drugs called nuclear transporter inhibitors, chemotherapy, radiation therapy, stem cell and bone marrow transplant, adoptive cellular therapies (for example, CAR T-cell therapies) or a combination of methods. In addition, radiation therapy, balloon kyphoplasty and vertebroplasty are used to treat painful bone disease caused by multiple myeloma, and our Palliative Care team can assist you if you experience neuropathy.

The choice of treatment depends mainly on how advanced the disease is and whether or not you have symptoms. If you have multiple myeloma without symptoms, you may not need cancer treatment right away. In that case, you may have what is called smoldering myeloma, and your doctor will monitor your health closely so treatment can start if you do begin to have symptoms.

If you already have symptoms (CRAB criteria) or markers that indicate a high risk for progression (specific blood, imaging and bone marrow results) you will likely receive induction therapy, which uses combination therapy to cause remission, reducing the cancer cells in your body significantly. Often a stem cell transplant is part of the treatment plan.

Because standard treatments do not always control the cancer, eligible multiple myeloma patients should consider the option of enrolling in a clinical research study of promising new treatments that are not widely available.

The Myeloma team at Roswell Park follows the Clinical Practice Guidelines in Oncology™ developed by the National Comprehensive Cancer Network (NCCN). Jens Hillengass, MD, our Chief of Myeloma, serves on the NCCN panel of experts that develops the guidelines, which are internationally recognized standards for treating cancer patients. He also is a member of the International Myeloma Working Group, which develops guidelines for the diagnosis and treatment of myeloma and related diseases.